Healthcare Provider Details

I. General information

NPI: 1902538093
Provider Name (Legal Business Name): CONNOR JAMES RADEMAKER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2022
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 PATERSON ST # 3100
NEW BRUNSWICK NJ
08901-1962
US

IV. Provider business mailing address

1 FEDERAL ST STE 200
CAMDEN NJ
08103-1088
US

V. Phone/Fax

Practice location:
  • Phone: 732-235-6631
  • Fax:
Mailing address:
  • Phone: 848-288-6935
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number25MA13152100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: